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Preventing osteoporosis

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Are you over age 50? Female? Asian or Caucasian? Do you smoke? Are you eating enough calcium-rich foods? All of these are major risk factors for osteoporosis—a general thinning or weakening of bones, which may eventually lead to fractures.

“That’s why we care so much about this disease,” said Laisvyde Smajkic, MD, a rheumatologist who runs the Arthritis Clinic at Weiss.

In the United States, more than 10 million people have osteoporosis, and more than 34 million have low bone mineral density, a precursor for the disease. It occurs more often in women due to the hormonal changes that accompany menopause; however, it can occur in men, too.

Throughout our lives, bones “are continually undergoing renewal,” Dr. Smajkic said. During the renewal process, bone cells called osteoclasts consume older bone material while osteoblasts create new bone. When that system falls out of balance—which can happen for various reasons, including hormonal changes—loss of bone density begins.

“That’s why it’s important that we build up bone mass, because we (eventually) lose it. We all lose it,” said Dr. Smajkic.

Calcium and vitamin D play major roles in building up bone mass. Vitamin D helps the body absorb calcium when we eat, and calcium helps build bones.

“Vitamin D has a direct effect on bone remodeling and muscle strength. It’s very important, but we didn’t know a lot about this vitamin (until recently),” Dr. Smajkic said.

The optimal way to get vitamin D is from sun exposure, but unfortunately, because people now have to protect themselves from increasing skin cancer risks, they inadvertently block out vital vitamin D. And according to Dr. Smajkic,” We’re paying the price for this.”

Calcium is important, too. Pre-menopausal women should consume about 800 mg of the mineral each day to avoid bone loss, while postmenopausal women may need as much as 1500 mg a day. This can come from dietary sources such as yogurt, cheese, milk, kale, broccoli, spinach and almonds.

To determine the amount of calcium various foods offer, remember this: One cup of yogurt contains about 300 mg of calcium—which is equal to 1.5 oz. of cheddar cheese, 8 fl. oz. of milk, 1.5 cups of cooked kale, 2.25 cups of cooked broccoli, or 1 cup of cooked spinach.

So eat up! And as you age, make sure to see your doctor for regular bone density scans to prevent fractures from a disease that often attacks silently.

“We don’t feel this disease. It’s not painful unless you develop a fracture,” Dr. Smajkic said, adding that two-thirds of spinal fractures go unnoticed, but typically happen as the result of osteoporosis. “That’s why you lose height, and any fracture can lead to chronic pain, deformity, depression and disability.”

While genetics play a 50 percent role in determining whether a person will develop osteoporosis, other major risk factors include:

  • Low bone mass/density
  • Advanced age
  • Gender (female)
  • Ethnicity (Caucasian or Asian)
  • Family history
  • Low body weight
  • Physical inactivity
  • Smoking
  • Nutritional factors (calcium intake <400 mg/day)
  • Low vitamin D levels

Disorders or activities that may contribute to osteoporosis:

  • Corticosteroid use
  • Hyperthyroidism
  • Hyperparathyroidism
  • Pregnancy (reversible)
  • Inflammatory disorders
  • Immobilization
  • Weightlessness
  • Alcoholism
  • Gastrectomy or other stomach problems that interfere with calcium absorption
  • Certain drugs (heparin, anticonvulsives, aromatase inhibitors)

Visit the National Osteoporosis Foundation for more information. Contact Dr. Smajkic and the Arthritis Program directly at (773) 913-2585 to set up an appointment.

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